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<head>
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<title>Member Qualification Processing Form</title>
</head>
<body bgcolor="#ffffff">

<form:form action="editApplicant.do" modelAttribute="applicant">


<p align="center"><font size="4"><u><strong>Member Qualification 
Processing</strong></u></font></p>

<p align="right"><strong><%= new java.util.Date()%></strong></p>
<table height="8" cellspacing="0" cellpadding="3" width="100%" align="center" 
bgColor=#ffff99 border=0>
  <tbody>
  <tr>
    <td>Primary Member Name:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
    	<form:input readonly="true" path="firstName" />
    	<form:input readonly="true" path="middleName" />
		<form:input readonly="true" path="lastName" />
	</td>
    <td>Primary Member Id: <form:input readonly="true" path="id" /></td></tr>
  <tr>
    <td>Primary Member Address:</td>
    <td>Primary&#8217;s Home Ph: <form:input readonly="true" path="homePhone"/></td></tr>
  <tr>
    <td>&nbsp;&nbsp;<form:input readonly="true" path="address1"/>,
    	<form:input readonly="true" path="address2"/>,
    	<form:input readonly="true" path="city"/>,
    	<form:input readonly="true" path="state"/>,
    	<form:input readonly="true" path="zip"/>
    </td>
    <td>Primary&#8217;s Cell Ph&nbsp;&nbsp; : <form:input readonly="true" path="cellPhone"/></td></tr>
  <tr>
    <td>Primary&#8217;s 
      Email&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
      :&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <form:input readonly="true" path="email"/>
      </td>
    <td></td></tr></tbody></table>
<table cellspacing="0" cellpadding="3" width="100%" align="center" border="0">
  <tbody>
  <tr>
    <td colspan="2">&nbsp;</td></tr>
  <tr>
    <td>
      <p><font size="4"><u><strong>Submitted Documents:</strong></u></font></p></td>
    <td>
      <p align="right">Document Submission Date: <form:input size="10" path="lastDocDate"/></p></td></tr></tbody></table>
<table height="10" cellspacing="0" cellpadding="3" width="100%" align="center" 
bgColor=#bbe1bf border=0>
  <tbody>
  <tr>
    <td>Document 1: </td>
    <td><form:input path="document1"  maxlength="100" size="75"/></td></tr>
  <tr>
    <td>Document 2: </td>
    <td><form:input path="document2"  maxlength="100" size="75"/></td></tr>
  <tr>
    <td>Document 3:</td>
    <td><form:input path="document3"  maxlength="100" size="75"/></td></tr>
  <tr>
    <td>Document 4:</td>
    <td><form:input path="document4"  maxlength="100" size="75"/></td></tr>
  <tr>
    <td>Document 5:</td>
    <td><form:input path="document5"  maxlength="100" size="75"/></td></tr>
  <tr>
    <td>Document 6:</td>
    <td><form:input path="document6"  maxlength="100" size="75"/></td></tr></tbody></table>
<table cellspacing="0" cellpadding="3" width="100%" align="center" bgcolor="#d5d5ea" 
border=0>
  <tbody>
  <tr>
    <td>Current&nbsp;Qualification Status&nbsp;&nbsp;&nbsp;&nbsp; :</td>
    <td width="15%" colspan="2"></td>
    <td><form:input readonly="true" path="status"/></td>
    <td></td></tr>
  <tr>
    <td>Change Qualification Status To:</td>
    <td width="15%">
      <p><form:radiobutton path="status" value="Approved"/> 
      Approved</p></td>
    <td><form:radiobutton path="status" value="Denied"/> Denied</td>
    <td>
      <p><form:radiobutton path="status" value="Manager Approval"/>  
      Manager Approval</p></td>
    <td>
      <p><form:radiobutton path="status" value="Pending Additional Information"/>Pending Additional Info.</p>
      </td></tr></tbody></table></ P>
<p><font size="4"><strong><u>
<table cellspacing="0" cellpadding="3" width="100%" align="center" border="0">
  <tbody>
  <tr>
    <td><font size="4"><strong>Evaluator Comments:</strong></font></td>
    <td></td></tr>
  <tr>
    <td>
      <p align="left"><span 
      style="FONT-SIZE: 12pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA"><font 
      size=4><strong><u> <form:textarea path="comments" rows="4" cols="65" /> </u></strong></font></span>&nbsp;</p></td>
    <td></td></tr></tbody></table></u></strong></font>
    <strong>Evaluator Name:</strong>&nbsp;&nbsp;&nbsp;&nbsp; <form:input maxlength="50" size="30" path="evaluatorName"/> 
<table cellspacing="0" cellpadding="3" width="100%" align="center" border="0">
  <tbody>
  <tr>
    <td></td>
    <td>
      <p align="right"><input style="WIDTH: 173px; HEIGHT: 24px" type="submit" size="24" value="UPDATE/SAVE" name="updateButton"></p></td></tr>
  <tr>
    <td></td>
    <td>
      <p align="right"><input style="WIDTH: 171px; HEIGHT: 24px" type="button" size="19" value="EXIT Without Saving" name="exitButton"></p></td></tr></tbody></table></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt">&nbsp;</p>

</form:form>

</body>
</html>